Potential Source Of Transmission Research Articles

Captive Green Iguana Carries Diarrheagenic Escherichia coli Pathotypes.

The green iguana appears to be a carrier for bacteria causing gastrointestinal infections in humans. The presence of diarrheagenic E. coli (DEC) pathotypes, however, has not been studied in this reptile. The aim of the current work was to investigate the prevalence of DEC in the intestines of 240 captive green iguanas, their phylogenetic groups, and the antibiotic susceptibility profile. E. coli strains were isolated from 41.7% (N = 100/240) of the intestinal content of green iguanas. DEC strains was identified in 25.9% of the screened population and were detected in the majority (62%, p = 0.009) of those reptiles carrying E. coli strains. Among DEC strains, STEC strains carrying the stx1 gene were the most prevalent pathotype isolated (38.7%), followed by EAEC and ETEC (27.4% each). Genetic markers of DEC strains belonging to the EHEC pathotype were not detected. More than a half of DEC strains were classified into the Clade I-II phylogroup (64.5%), followed by the phylogroup A (14.5%). The antibiotic susceptibility method demonstrated that a high proportion of DEC strains were resistance, or non-susceptible, to carbenicillin, amikacin, and ampicillin. We conclude that the green iguana kept in captivity is a carrier of DEC strains bearing resistance to first-line antibiotics, including penicillins. Given the increase presence of the green iguana in Latin American households, these reptiles represent a potential source of transmission to susceptible humans and therefore a potential source of gastrointestinal disease.

The Potential Sources of Transmission and Distribution of Lymphatic Filariasis in Semarang City, Central Java, Indonesia

Lymphatic Filariasis (LF) is a neglected tropical disease caused by filarial worms. Semarang City has an increasing number of LF. The aim of this study was to investigate potential sources of transmission and distribution of LF. It was descriptive research using cross-sectional design. The sample were 28 LF cases. The variables studied were level of knowledge, physical and biological environmental factors, and provision of health service. Data were collected with interview and observation. Data were analysed descriptively and spatially. The results showed that LF cases were distributed in centre of Semarang City, especially in the coastal area. Poor drainage and stagnant water around the houses were potential breeding places for mosquitos, which are suspected as a vector of LF transmission. Physical and biological environmental factors around the houses of LF patient may possibly be sources of distribution and transmission of LF. It was indicated with the existence of mosquito larvae in any habitats.

Longitudinal Surveillance for SARS-CoV-2 Among Staff in Six Colorado Long Term Care Facilities: Epidemiologic, Virologic and Sequence Analysis

Background: SARS-CoV-2 emerged in 2019 and has become a major global pathogen. Its emergence is notable due to its impacts on individuals residing within long term care facilities (LTCFs) such as rehabilitation centers and nursing homes. LTCF residents tend to possess several risk factors for more severe SARS-CoV-2 outcomes, including advanced age and multiple comorbidities. Indeed, residents of LTCFs represent approximately 40% of SARS-CoV-2 deaths in the United States.Methods: To assess the prevalence and incidence of SARS-CoV-2 among LTCF workers, determine the extent of asymptomatic SARS-CoV-2 infection, and provide information on the genomic epidemiology of the virus within these unique care settings, we sampled workers for 8-11 weeks at six Colorado LTCFs with nasopharyngeal swabs, determined the presence and level of viral RNA and infectious virus within these samples, and sequenced 54 nearly complete genomes.Findings: Our data reveal a strikingly high degree of asymptomatic/mildly symptomatic infection, a strong correlation between viral RNA and infectious virus, prolonged infections and persistent RNA in a subset of individuals, and declining incidence over time.Interpretation: Our data suggest that asymptomatic SARS-CoV-2 infected individuals contribute to virus persistence and transmission within the workplace, due to high levels of virus. Genetic epidemiology revealed that SARS-CoV-2 likely spreads between staff within an LTCF.Funding Statement: Colorado State University Colleges of Health and Human Sciences, Veterinary Medicine and Biomedical Sciences, Natural Sciences, and Walter Scott, Jr. College of Engineering, the Columbine Health Systems Center for Healthy Aging, and the National Institute of Allergy and Infectious Diseases.Declaration of Interests: The authors declare no conflicts of interest.Ethics Approval Statement: This study was reviewed and approved by the Colorado State University IRB under protocol number 20-10057H.

Surface Contamination of CT and MRI Equipment—A Potential Source for Transmission of Hospital-Acquired Infections

Hospital-acquired infections (HAIs) are a major problem for health care worldwide. These infections cause additional suffering for the patient and infer major societal costs. There has been extensive research on infection transmission in health care, but to a lesser extent within the field of radiology. The purpose of this study was to identify selected hand-touched surfaces inside and outside the computed tomography (CT) and magnetic resonance imaging (MRI) examination rooms which are prone to contamination and which could represent a risk for transmission of HAI pathogens. We also aimed to examine differences in bacterial contamination between public and private radiology departments. Six public and four private radiology departments participated in the study. Bacterial samples were taken from ten predetermined surfaces inside and outside CT and MRI examination rooms. Sampling was carried out between patients after standard cleaning procedure, using flocked nylon swabs. The swab was applied over a 100 cm2 surface, and after cultivation, bacterial colony-forming units (CFU) per cm2 were calculated. Bacterial CFU were found on almost all selected surfaces. The highest numbers were found on keyboards, chairs of the patient changing rooms, headphones, and the alarm control/buzzer. There was no significant difference between public and private radiology departments. No multidrug-resistant microorganisms such as methicillin-resistant Staphylococcus aureus, extended-spectrum beta-lactamase–producing Enterobacterales, or carbapenemase-producing Enterobacterales were found in any of the investigated radiology departments. Both the CT and MRI equipment in public and private radiology departments may be potential sources of pathogenic bacteria, and disinfection between patients should be improved.

Prevalence of Needle Stick Injuries and Utilization of Post-Exposure Prophylaxis Among Resident Doctors in a Teaching Hospital in Port Harcourt

Background: Needlestick injuries (NSIs) are percutaneous injuries sustained with sharp equipment used in the delivery of medical care. They are common occupational hazards occurring among health care workers and are a potential source of transmission of bloodborne pathogens. descriptive cross-sectional study was conducted to determine the prevalence and identify predisposing factors to needle stick injuries and to assess rates of utilization of post-exposure prophylaxis among resident doctors in a tertiary hospital in Nigeria. Methods: A descriptive cross-sectional study design was used. A multistage sampling method was used to recruit 210 resident doctors of the University of Port Harcourt teaching hospital into the study. Data was collected using a structured self-administered questionnaire to ascertain the history of a needle stick injury, the number of injuries in the past one year, perceived cause of the injury, reporting of the injury, the use and completion of post-exposure prophylaxis. Findings: Overall response rate was 94.5%. The study found a 53.8% lifetime prevalence of NSIs among resident doctors. Annual prevalence was 50.9%. The prevalence was significantly higher among senior registrars(65.1%) than junior registrars (p=0.006), among residents in Paediatrics (75.6%), Obstetrics and Gynaecology (72.7%) and Surgery(63.9%) than among those in other departments (p<0.001), and among residents who had spent three years or more (65.7%) than those who had spent less than three years (p<0.001). The most frequently reported factors that predisposed residents to needle stick injuries were excessive workload (77.9%), insufficiency of consumables (72.6%), long working hours (70.2%) and lack of personal protective equipment (69.7%). All the residents were aware of the risk of transmission of infection through NSIs. About 77.4% of residents had negative attitudes of recapping needles, 66.1% had negative attitudes of not reporting NSIs to appropriate authorities, whereas 73.2% had positive attitudes of taking protective actions in response to NSIs. Only 8.9% of the residents utilized post-exposure prophylactic services after sustaining NSIs. In 51.8% of cases, the needle had been used on the patient prior to the injury. In 25.9% of these cases, the injury involved a high-risk patient (HIV, Hepatitis B or C infected). study found the risk of transmission of HIV following a needle stick injury to be 0.48%. Interpretation: Needlestick injuries are common among resident doctors however, a large number of these injuries go unreported, the level of awareness about NSIs and the risk of transmission of infection is high, however, the attitude toward preventive measures and use of post-exposure prophylactic services was poor. Even though the risk of disease transmission is relatively low, there is an urgent need for the improvement of doctors' safety culture towards infection prevention which requires in-service training, addressing problems of man-power and shortage of consumables. Funding Statement: The authors reported: This study was author funded. Declaration of Interests: The authors stated: No potential conflict of interest relevant to this article is reported. Ethics Approval Statement: Informed consent was obtained. Confidentiality was maintained. Participation was voluntary, Ethical approval was obtained from the University of Port Harcourt Ethics committee.

Raw meat-based diets for companion animals: a potential source of transmission of pathogenic and antimicrobial-resistant Enterobacteriaceae.

Feeding pets raw meat-based diets (RMBDs) has become increasingly popular but may constitute a risk due to the contamination with pathogenic and antimicrobial-resistant (AMR) bacteria. The aim of this study was to evaluate commercially available RMBDs with regard to microbiological quality and occurrence of AMR Enterobacteriaceae. Of 51 RMBD samples, 72.5% did not meet the microbiological standards for Enterobacteriaceae set out by EU regulations for animal by-products intended for pet food. Furthermore, Salmonella was detected in 3.9% of the samples. AMR bacteria were found in 62.7% of the samples, the majority thereof were resistant to third-generation cephalosporins due to the production of extended-spectrum β-lactamases (ESBLs) including CTX-M-1, which is widespread in livestock, and CTX-M-15, which is the most common ESBL variant worldwide. Colistin- and aminoglycoside-resistant isolates, producing MCR-1 and RMTB, were identified in 3.9 and 2% of the samples, respectively. The majority of the AMR Escherichia coli belonged to commensal groups A or B1 and were associated with clonal complexes CC155 and CC10. Two belonged to the emerging extraintestinal pathogenic CC648, and one to the globally disseminated uropathogenic E. coli sequence type ST69, suggesting zoonotic potential. The microbiological quality and the high prevalence of AMR producing Enterobacteriaceae in RMBDs raise concerns for animal and public health.

Geohelminth contamination of raw vegetables as sold in some selected markets in Kaduna Metropolis, Nigeria

Vegetables are a very essential part of the human diet providing dietary fibre, vitamins and minerals. A study was carried out to determine the geohelminth contamination of raw vegetables sold in some selected markets within the Kaduna Metropolis. A total of three hundred (300) vegetable samples were bought across the markets and the presence of geohelminth parasites in the vegetables were determined using floatation, sedimentation and microscopy methods. The results revealed out of the five different vegetables examined, lettuce (Lactuva sativa) had 80% contamination and 9(47.4%) multi parasitic eggs or larva. Barkin Ruwa Market sourced vegetable were contaminated with 7(28.0%) multi parasitic eggs or larva, while Mando Market samples vegetables had 2(8.0%) multi parasitic eggs or larva. The eggs of Ascaris lumbricoides, hookworm, Strongyloids and Trichuris trichiura were detected in the vegetables. The most prevalent eggs were A. lumbricoides eggs and Trichuris trichiura had the least. The study revealed that raw vegetables as sold in markets could be potential sources of transmission for intestinal parasites in this study and consumers of raw vegetables could be at risk of infection. There is a need to thoroughly wash raw vegetables bought from the markets to prevent incidence of parasitic zoonoses. Keywords: Vegetables; parasites; eggs; contamination.

Variation in antibiotic susceptibility and presence of type VI secretion system (T6SS) in Campylobacter jejuni isolates from various sources

Campylobacter jejuni is a major cause of infectious diarrhea in humans. The bacterium can be transmitted through contaminated poultry meat and waste water. We report the presence of C. jejuni from potential transmission sources including egg shells, poultry waste, waste water and migratory bird droppings with a prevalence rate of 78%, 66%, 86% and 70% respectively. Antibiotic resistance profile showed high number of isolates resistant to multiple antibiotics including 4th generation cephalosporins. C. jejuni isolates were further screened for presence of T6SS, an important virulence factor. None of the C. jejuni isolates from migratory birds carried a T6SS, whereas highest prevalence of T6SS isolates was observed in waste water samples, followed by poultry waste and egg shells. To determine virulence potential of the isolates, hemolytic activity of isolates was compared. Although variation in hemolytic potential between isolates from different sources was noted, higher hemolytic activity was observed for isolates possessing hcp, a T6SS gene. Furthermore, presence of T6SS affords the bacterium some survival advantage when compared to T6SS competent Helicobacter pullorum which occupies the same niche. Taken together our findings indicate that C. jejuni with T6SS have a fitness advantage increasing their isolation frequency from waste water and poultry waste.

Efficacy of a novel ultraviolet light-emitting diode device for decontamination of shared pens in a health care setting

Shared pens and styluses are a potential source for transmission of health care-associated pathogens and respiratory viruses in health care facilities. A novel ultraviolet light-emitting diode device was effective in reducing bacteria and viruses inoculated on pens and in reducing methicillin-resistant Staphylococcus aureus transferred to pens by colonized patients. The device could be useful in reducing the risk of transmission of pathogens by shared writing utensils.

Prevalence of Staphylococcus aureus methicillin-sensitive and methicillin-resistant nasal carriage in food handlers in Lebanon: a potential source of transmission of virulent strains in the community.

PurposeTo determine the prevalence and virulence determinant genes of nasal colonization by Staphylococcus aureus among food handlers in Tripoli, Lebanon.MethodologyWithin a cross-sectional study design, nasal swab specimens were collected. Epidemiological and microbiological investigations were performed through conventional culture and MALDI-TOF-MS. Antibiotic susceptibility patterns and genetic virulence determinants including enterotoxin genes were also investigated for all isolates.ResultsThe data herein show that S. aureus nasal carriage is highly prevalent (23.8 %), and that the rate of methicillin-resistant S. aureus (MRSA) carriage was twice as high as in our last report in 2008. Several enterotoxin genes were detected in five isolates including one MRSA and four methicillin-sensitive S. aureus .ConclusionTo our knowledge, this is the first investigation in the last decade to examine the carriage prevalence of S. aureus among food handlers in Lebanon. This work reports a concerning level of MRSA, and enterotoxin-producing S. aureus nasal carriage, which could potentially act as a contamination reservoir and lead to food poisoning.

Contamination of the Preservation Solution in Solid Organ Transplantation

IntroductionPreservation solutions (PS), in which grafts for patients undergoing liver transplantation are stored, represent a medium suitable for microorganism growth and a potential source for transmission of pathogenic germs to the transplant recipients. The aim of the present study was to review the relevant literature for the incidence and predictors of positive microbiological findings in the PS. Patients and MethodsWe performed a literature review of publications on bacterial and fungal contamination of PS during cold organ storage focusing on its impact on bacteremia and/or nosocomial infection of the recipient. ResultsOverall 19 studies were reviewed, published between the years 2000 and 2016, that encompassed a total of 5647 patients. Positive cultures were identified in 1428 patients (25%). The documentation of bacteremia showed a wide deviation with documented ranges between 0% and 69%. Data on the identification of same species or of related nosocomial infections were only sparsely available; same species were found in a rate of 0% to 8%, and nosocomial infections were attributed to them in an incidence of 0% to 19%. ConclusionsOur study underlines both the limited published data and the contradictory available information on contamination of preservation solution in solid organ transplantation, not allowing for any recommendations. The necessity for prospective, multicentric studies on this topic is mandatory.

Potential transmission sources of Helicobacter pylori infection: detection of H. pylori in various environmental samples

Helicobacter pylori is one of the most common human infectious agents which may be transmitted via water. This study was designed to test H. pylori presence via molecular methods in various aquatic environments as well as sewage sludge (SS) to understand the role of these environments in the pathogen's transmission. specific primers for the 16S rRNA and ureA genes of H. pylori were used in a nested and semi-nested PCR, respectively. Detection sensitivity of H. pylori in environmental samples by semi-nested PCR was also compared with real-time PCR. Analysis of fecal coliforms (FC) as pollution indicator bacteria was also performed. H. pylori 16S rRNA gene was detected in 36% (14/39) of wastewater samples and 8% (2/25) of water samples, while amplification of ureA gene yielded only two positive results. None of the SS samples were positive for H. pylori and real-time PCR could not identify H. pylori in any of the samples. The results showed no correlation between the presence of H. pylori and FC. Our result revealed the widespread presence of H. pylori in wastewater samples which indicates wastewater may be a source for dissemination and transmission of H. pylori infection. Further research is needed to determine the risk of H. pylori in wastewater reuse for irrigation of crops.

Independent Origin of Chytrid Fungus in China

Chytridiomycosis is an emerging infectious fungal disease of wildlife worldwide. This disease implicated in the decline or extinction of about 200 amphibian species, thereby contributing to the ongoing sixth great extinction event on the world. With this emerging disease, international trade, specifically import and export from unknown sources, has been associated with novel pathogen transmission. Thus, identifying the potential sources of transmission of the pathogen is a key step in international risk management. China may unknowingly be an important source of pathogen in this regard and a «mixer» of pathogens in the import and export trade. Here, we report evidence for an independent origin of Batrachochytrium dendrobatidis in China. We evaluated American bullfrog ( Lithobates catesbeianus ) introductions over time and performed phylogenetic analyses of DNA recovered from native Chinese B. dendrobatidis infections in comparison with B. dendrobatidis DNA sequences from other geographically distinct isolates. It is hoped that this study can be used to improve international risk management of chytridiomycosis. The pathogenic mechanism and implications of B. dendrobatidis isolates from China warrants reassessment.

Healthcare-associated transmission of Panton-Valentine leucocidin positive methicillin-resistant Staphylococcus aureus: the value of screening asymptomatic healthcare workers

BackgroundThree patients hospitalised in the coronary care unit of a general district hospital (England, UK) were tested positive for Panton-Valentine leucocidin methicillin-resistant Staphylococcus aureus colonisation during their routine weekly screening for methicillin-resistant Staphylococcus aureus (MRSA). The isolates were indistinguishable and all three patients have previously had negative screening tests. The outbreak investigation team considered exploring the possibility of PVL-MRSA transmission from members of staff to the patients and potentially between members of staff.MethodAs part of the investigations, healthcare workers on coronary care unit and intensive care unit were screened for MRSA carriage.ResultsAmong 134 screened healthcare workers, five staff members (3.7%) were MRSA colonised. Among these isolates, four were Panton-Valentine leukocidin positive. However, only two healthcare workers had an indistinguishable isolate with the isolate identified among the colonised patients. Decolonisation treatment was offered to all colonised patients and healthcare workers.ConclusionIn low MRSA prevalence settings, healthcare workers may be a reservoir of MRSA and an important potential source of transmission to patients. Screening and decolonisation of colonised healthcare workers may provide a valuable strategy in managing linked hospital acquisitions and reduce the risk of occupationally acquired complications. MRSA mass screen of healthcare workers should be considered in transmission with a strain that has a potentially increased virulence, such as Panton-Valentine leucocidin methicillin-resistant Staphylococcus aureus.

Co-circulation dynamics and persistence of newly introduced clades of 2012 outbreak associated West Nile Virus in Texas, 2012–2015

The second largest outbreak of West Nile encephalitis and West Nile fever ever recorded occurred in the United States (U.S) in the summer of 2012. The outbreak was related to the widespread circulation of closely related clades, or groups, of West Nile virus (WNV) into multiple states where they were not previously found. Whether the invading 2012 strains were able to circulate and overwinter in states with their own endemic population of WNV is unknown and the effect of viral genetics on adaptation and persistence in a new ecological niche is unclear. In this study, we sequenced 70 mosquito isolates from multiple counties throughout Texas in 2012–2015. We identified isolates representative of previously described 2012 WNV groups (Groups 8–10) and discovered a novel group which we called Group 11. Although we identified isolates representative of WNV endemic (2/70) to Texas, most isolates (68/70) were related to the invading 2012 strains, and of these Group 10 (45/68) was predominant. We also observed differences among the 2012 WNV groups correlating to their genotype. Group 10 WNV in Texas, which carry two putative positively selected variants, had limited introductions into Texas, wide circulation, and strong evidence of continued persistence perhaps indicative of overwintering. In contrast, Groups 8 and 11, without positively selected variants, had multiple introductions into Texas, limited circulation, and limited persistence. Lastly, we identified a potential transmission source in New York for incoming Group 8 WNV into Texas. Altogether our study suggests that mutations in the WNV genome may influence the range and dynamics of WNV circulation, and the ability of different strains to persist in new ecological niches.

Contaminated clothing of methicillin-resistant Staphylococcus aureus (MRSA) carriers is a potential source of transmission

We examined the burden of methicillin-resistant Staphylococcus aureus (MRSA) on the clothing of MRSA carriers in a hospital and long-term care facility and assessed the potential for clothing to be a source of transmission. Of 50 MRSA carriers studied, 37 (74%) had MRSA recovered from clothing. For a subset of carriers with clothing contamination, transfer of MRSA from clothing to gloved hands and to a wheelchair occurred in 8 of 13 (62%) and 5 of 10 (50%) carriers, respectively. These findings suggest that measures to reduce clothing contamination should be investigated as a potential means to reduce MRSA transmission in healthcare settings.

Spatial and temporal variation in the community prevalence of antibiotic resistance in Bangladesh: an integrated surveillance study protocol

IntroductionIncreasing antibiotic resistance (ABR) in low-income and middle-income countries such as Bangladesh presents a major health threat. However, assessing the scale of the health risk is problematic in the absence...

Clostridium difficile Whole Genome Sequencing Reveals Limited Transmission Among Symptomatic Children: A Single-Center Analysis.

Although pediatric Clostridium difficile infections (CDIs) are increasing, C. difficile transmission patterns among children are poorly understood. We performed whole genome sequencing (WGS) on C. difficile isolates collected from children diagnosed with CDI between December 2012 and December 2013 at a single academic medical center. Genome sequences of isolates from CDIs diagnosed ≥8 weeks after study initiation were compared to all study isolate genome sequences. Among patients with isogenic isolates (≤2-3 core genome single nucleotide variants [SNVs] identified by pairwise SNV analyses), common inpatient and/or outpatient healthcare exposures were investigated. Among 131 CDIs in 107 children, WGS identified 104 genetically distinct isolates. Of 84 incident CDIs occurring ≥8 weeks after study initiation, only 10 (11.9%) were caused by a strain isogenic to another cohort CDI isolate (putative transmission events). Proportions of each CDI class putatively associated with transmission were hospital-onset healthcare facility-associated (HCFA), 2/16 (12.5%); community-onset HCFA, 1/17 (5.9%); indeterminate, 1/11 (9.1%); community-associated (CA), 5/40 (12.5%); and recurrent, 1/21 (4.8%). Transmission events among CA and HCFA CDIs were similarly infrequent (5/40 [12.5%] vs 3/33 [9.1%]; P = .64). Shared healthcare facility exposures were only identified among 7/10 putative transmission events. Potential community transmission (same postal code) was not identified. WGS identified a highly diverse group of C. difficile isolates among children with CDI, including those with HCFA CDI. Clostridium difficile transmission among symptomatic children was very uncommon. Among putatively transmitted cases, investigation of shared healthcare exposures often did not identify a potential transmission source.

Molecular Epidemiology of Norovirus in Asymptomatic Food Handlers in South Korea

Norovirus (NoV) is the most common cause of acute gastroenteritis in all age groups worldwide. In this study, prevalence of asymptomatic norovirus infection was investigated in food handler being employed at food catering facilities in South Korea. A total of 2,729 fecal specimens from asymptomatic food handlers were analyzed, and 1.06% of food handlers (29/2,729) had asymptomatic NoV infection. Of these, 17.2% (5/29) were positive for NoV GI and 82.7% (24/29) were positive for NoV GII. Especially, sequencing and phylogenetic analysis showed that GII-4 was the most prevalent genotype and a large number of asymptomatic food handlers were infested with norovirus GII-4 strains. The results of this study show that asymptomatic food handlers may be potential transmission sources for NoV infection. These results emphasize the need for training of food catering employees about norovirus prevention. Asymptomatic norovirus infection should receive more attention.

Are Patients with Prior Clostridium difficile Infection (CDI) a Potential Source of Transmission during Hospital Admissions?

BackgroundMany patients with Clostridium difficile infection (CDI) continue to shed spores asymptomatically after completion of CDI therapy. However, the duration of shedding and the potential for transmission during subsequent healthcare exposures is unknown.MethodsDuring a 6-month period, we collected perirectal, groin, and skin (chest/abdomen and hands) cultures for toxigenic C. difficile from patients with a prior history of CDI who were admitted to the hospital. We calculated the frequencies of perirectal and skin shedding of C. difficile at the time of admission, stratified by the time since the prior CDI diagnosis.ResultsOf 28 patients with a prior history of CDI enrolled in the study, 10 (36%) had positive perirectal cultures for toxigenic C. difficile upon admission, and 6 of 10 (60%) had positive skin cultures. The figure shows the percentages of CDI cases with positive perirectal, groin, or skin cultures, stratified by the time since the prior CDI diagnosis.ConclusionPatients with prior CDI often shed spores asymptomatically during hospital admissions. Further studies are needed to determine whether these carriers contribute significantly to transmission.FigurePercentages of CDI cases with positive perirectal, groin, or skin cultures, stratified by the time since the prior CDI diagnosisDisclosures All authors: No reported disclosures.